The Department for Health and Social Care has announced a new strategy to improve circularity in the NHS. This initiative, Design for Life, forms part of a broader effort to lessen the use of disposable medical items, which contributes to an estimated 156,000 tonnes of clinical waste produced annually in England. The strategy outlines ambitious targets for reducing single-use devices, improving reuse and recycling practices, and lowering the NHS's carbon footprint by adopting more sustainable technologies.
Whilst the strategy primarily focuses on MedTech and operational waste, there is opportunity to reduce waste on a larger scale through construction activity too. There are reportedly 2,000 NHS buildings that are outdated, and expanding trust estates through sustainable construction methods could significantly contribute to further waste reduction. As part of the reuse and recycling strategy, incorporating circular economy principles, such as repurposing equipment and buildings along with Modern Methods of Construction (MMC), could be key, and would help reduce the NHS’s carbon footprint further as well.
With this in mind, what can the Government do to extend the Design for Life strategy to NHS estate management and embrace circular economy?
Embracing sustainability
Whilst the Government’s announcement of the strategy is promising, it’s essential that NHS stakeholders ensure that what’s promised is delivered in order to meet the ambitious targets that have been set out in the roadmap.
The document outlines initiatives to transition the healthcare sector towards a circular economy by 2045, focusing on improving supply chain resilience and reducing waste and emissions to generate cost savings. Key actions include cutting down on single-use devices and recycling or reusing items where necessary. Single-use scissors, for example, are a significant area of waste – a single ophthalmology department at Northampton Hospitals NHS Trust saved £12,000 in just one year by switching from disposable to reusable scissors. Whilst the need for single-use consumable items in healthcare settings will always be there, the significant volume of disposable items used in the NHS only highlights the need for more sustainable practices.
While reducing the use of single-use items will improve sustainability, the NHS estate needs sustainable modernisation, which the circular economy could play a major role in achieving. The NHS estate includes over 10,000 buildings, two thirds of which are over 75 years old, according to NHS Digital data. Many of these outdated structures fail to meet the demands of a modern health service, highlighting the urgent need for upgrades, however, upgrading existing buildings alone will not suffice to meet the growing capacity and sustainability needs. Stakeholders must explore strategic, sustainable methods to improve the infrastructure while ensuring that patient care is not compromised.
One effective way to extend the waste strategy to estate management is by utilising MMC and modular building practices that enable more efficient, less labour-intensive construction, reducing both waste and the environmental impact of NHS building projects.
Sustainable estate management
MMC, including modular buildings, is at the forefront of sustainable building practices, offering significant waste reduction benefits. Offsite manufacturing minimises waste from the outset by producing components to exact specifications, resulting in fewer offcuts and surplus parts. Additionally, the lean manufacturing practices used with MMC offer operational efficiency, aiming to maintain high productivity while further reducing waste.
A major issue in older NHS buildings is energy waste due to inadequate insulation from the use of materials with poor thermal properties and lack of cavity walls. In contrast, modular buildings are designed to prevent heat loss as they are built with better quality insulation. The prefabrication of the units in controlled factory environments minimises thermal bridges, making them much more airtight than their traditional counterparts, reducing places where air can escape.
Another advantage of modular buildings is their design flexibility. Interior layouts can be easily modified to meet the changing needs of healthcare services. For example, a modular building initially designed for one purpose can be repurposed after a few years, such as adapting an office space into a discharge lounge as patient needs change over the years. Repurposing buildings in this way can reduce carbon emissions by up to 70% compared to constructing new facilities, as fewer materials are needed. With this in mind, the NHS needs to look at the longevity of its estates and how this can be implemented within its overall waste strategy.
Modular buildings also offer the ability to easily incorporate additional components that support sustainability goals. For example, spaces can be added for facilities like sterilisation rooms to heat and sanitise reusable appliances, or aerobic digesters to help with food waste. Incorporating eco-friendly features, like solar panels, smart plug sockets, and rainwater harvesting systems, offer both environmental benefits and cost savings. These additional components can be integrated seamlessly and efficiently during the design process, ensuring that the building can evolve with the needs of the NHS.
The adaptability of modular buildings makes it an ideal choice to help meet NHS’s sustainability targets and waste reduction goals.
A flexible approach to circular economy
By embracing non-traditional construction, the NHS can achieve a more sustainable and adaptable estate. Modular buildings not only reduce waste during the construction phase but also offer long-term benefits through their flexibility, energy efficiency, and potential for repurposing.
Contrary to popular belief, modular buildings can be provided quickly on both a long-term or permanent basis, depending on the site’s needs. Short-term rental also offers flexibility to extend the lease period for a longer period of time.
Both permanent and rental modular buildings can be designed with sustainability in mind, allowing healthcare facilities to meet government targets whilst managing costs effectively. From a cost perspective, long-term modular rental also allows NHS estates to benefit and meet sustainability targets without a large budget. After the contract period, the building can either be extended or taken away and repurposed elsewhere on the estate or even move to an entirely different project. This approach directly aligns with the NHS’s goals of reducing carbon emissions and minimising waste.
As the NHS advances toward its sustainability targets, it has the potential to set a precedent for other high-impact sectors, such as education, government, and retail. If successful, this strategy could inspire similar waste reduction practices across industries. However, stakeholders must remain committed to delivering on the promises made, ensuring that sustainable construction methods like MMC are fully integrated to reduce long-term waste and help meet environmental objectives.